Service Application Form

Two-Wheeler & Commercial Vehicle Insurance Renewal (Insurance & Renewal Assistance)

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Full Name *

Mobile Number *

Email Address (Optional)

Vehicle Registration Number *

Vehicle registration plate number

Vehicle Type *

Insurance Type Desired *

Previous Insurance Company (Optional)

Leave blank if expired long ago

Upload RC Copy (Front & Back) *

Allowed: PDF, JPG, PNG (Max 5MB). Stored in private encrypted vault.

Clear photo or PDF

Special Instructions or Notes (Optional)

Government / Base Fee: ₹850.00

Operator Facilitation Fee: ₹100.00

Total Payable Amount: ₹950.00

Pay Online via UPI / Rozipay

Instant dynamic UPI QR code generation, GPay, PhonePe, Paytm, or Card.

Pay at Branch Counter

Submit request online and pay cash/UPI directly at the selected shop counter.